HHS

Positive test results for EV-D68 in Hamilton - Sept. 18, 2014

News Release
September 18, 2014

Positive test results for EV-D68 in Hamilton

(Hamilton, ON) – Sophisticated laboratory testing conducted by the Hamilton Regional Laboratory Medicine Program (HRLMP) has confirmed with a high degree of certainty that there have been at least 14 cases of enterovirus D68 (EV-D68) in the Hamilton region.

In September 2013, the HRLMP virology laboratory introduced a new combined test for rhinovirus and enterovirus to improve the diagnosis of respiratory infections. The test is extremely sensitive, but does not distinguish rhinovirus from enterovirus. When lab staff noted an increase in positive test results over the past three weeks, additional testing was performed on 56 positive swabs collected from patients (most pediatric) in local hospitals. Enterovirus was found in 14 of these patients, and genetic sequencing revealed a 97-99 per cent match with EV-D68 in all 14 samples. Enteroviruses are viruses that usually enter the system through the gastrointestinal tract, and EV-D68 is one particular type of enterovirus which primarily affects the respiratory tract. It most commonly affects children, and behaves similarly to common rhinoviruses.

The National Microbiology Laboratory in Winnipeg is conducting further analysis of the samples, but those results will not be available for at least another week.

“While this result tells us that we have EV-D68 in our region, that is neither surprising, nor a cause for alarm for families,” says Dr. Lennox Huang, chief of pediatrics at McMaster Children’s Hospital.

“We see an increase in colds and viruses at this time every year and, although the EV-D68 strain was previously a relatively uncommon enterovirus in our area, we know from its impact in the U.S. that it rarely causes severe illness. There have been no deaths reported and in the majority of cases, EV-D68 causes only mild symptoms,” adds Dr. Huang.

McMaster Children’s Hospital is maintaining its usual high standard of infection control to help prevent the spread of any kind of virus. Currently, of the 14 positive cases of EV-D68, one is still admitted in the hospital. There were other, previously admitted children among the 14 positive cases. Their conditions improved and they were subsequently discharged over the past few days.
The medical team of pediatricians and infectious disease experts at McMaster Children’s Hospital offer the following advice to parents:

• Mild symptoms of EV-D68 may include fever, runny nose, sneezing, cough, and body and muscle aches. If your child has these symptoms, but is breathing relatively comfortably, care for them just as you would for any cold or flu. Testing for enterovirus is not needed in these cases.
• EV-D68, just like more common types of respiratory viruses, can cause difficulty breathing and wheezing. If your child is having trouble breathing, bring him or her to the Emergency Department immediately. Children who have asthma are particularly vulnerable and should be monitored closely.
• All children should get flu shots, especially if they have asthma or other chronic conditions. This year’s vaccine will be ready by about mid-October.
• As a family, learn and practice infection control practices: wash your hands frequently, cough into your sleeve or into a tissue that is disposed of immediately, and stay home from school or work if you have a cold or the flu.
Whenever a new strain of virus emerges, HRLMP lab scientists work quickly to develop and implement effective diagnostic tests. All lab specimens are being tested for enterovirus, and any additional positive samples will be checked for EV-D68. Within the next week, more rapid test methods being currently developed will enable detection within 24 hours, and confirmation within 48 hours, to better monitor for EV-D68 in hospitalized patients in our region.